微通道经皮肾镜碎石术后并发感染性休克1例报告并文献复习  

Septic Shock Following Mini-percutaneous Nephrolithotomy: a Case Report and Review of Literatures

作　　者：甘伟[1] 李云飞[1] 罗茂华[1] 张少峰[1] 

机构地区：[1]湖北医药学院附属人民医院泌尿外科,十堰442000

出　　处：《中国微创外科杂志》2015年第5期475-477,共3页Chinese Journal of Minimally Invasive Surgery

摘　　要：本文报道1例59岁右肾结石合并轻度积水女性患者,术前尿培养结果阳性,给予抗感染治疗后,行右侧微通道经皮肾镜碎石术(minimally invasive percutaneous nephrolithotomy,MPCNL),术中过程顺利,术后出现感染性休克表现:开始表现血氧饱和度低,不能脱离呼吸机,术后6 h出现血压下降,给予去甲肾上腺素泵入,更换抗生素,持续呼吸机辅助呼吸等治疗后患者治愈出院。我们认为对于结石较大、复杂,预计手术时间长的患者,尽量避免选用微通道;处理MPCNL术后并发感染性休克,重症监护、抗感染科、泌尿外科在内的多学科协作是必要的。[Summary] A 59-year-old woman was reported with calculi in both kidneys and mild hydronephrosis in the right kidney . Bacterial culture was positive from urine samples .After she was given antibiotics therapy , a mini-percutaneous nephrolithotomy was performed.The operation time was 100 min.Septic shock developed after the procedure , manifested as hypotension at 6 hours after surgery, low oxygen saturation , and needing mechanical ventilation . After norepinephrine administration , sensitive antibiotic treatment, and mechanical ventilation , the patient＇s condition was markedly improved and discharged . In conclusion, mini-percutaneous nephrolithotomy should be avoided in patients with large and complex stones or long operation time expectation .In case of septic shock , it is necessary for intensive care and multidisciplinary collaboration including urology and anti -infectious diseases .

关 键 词：微通道经皮肾镜碎石术 感染性休克 

分 类 号：R699.2[医药卫生—泌尿科学] R631.4[医药卫生—外科学]